Updated at 2:15 p.m., June 21 with comments from Missouri Gov. Mike Parson and the state health department director — The only abortion provider in Missouri has lost its license, but the clinic’s future remains unclear after a court hearing Friday morning in St. Louis.

Citing patient safety concerns, the Missouri Department of Health and Senior Services on Friday declined to renew a St. Louis Planned Parenthood clinic’s license to perform abortions. Officials said some abortions were not performed properly and failed.

Circuit Court Judge Michael Stelzer said the injunction he previously issued keeping the clinic open will remain in effect for now. It’s not known when he will make a final decision.

A Planned Parenthood doctor said the clinic will continue providing abortion services as long as it can.

“While Gov. [Mike] Parson and his political cronies are on the wrong side of history, nothing changes right now for patients who need access to abortion at Planned Parenthood,” said Dr. Colleen McNicholas, a physician at the clinic. “We will continue providing abortion care for as long as the court protects our ability to do so.”

McNicholas also said: “This decision signals the true motive behind this license-renewal mess that has left patients in limbo, uncertain about their health care — to ban abortion without ever overturning Roe v. Wade. Shame on Gov. Parson and DHSS Director Randall Williams.”

Williams defended the license-renewal denial at a press conference in Jefferson City, saying the health department found numerous violations during the state’s last inspection of the clinic.

“That would be like the FAA having a plane crash, in which people got injured and investigating it, and when people say, ‘Well, what? Did you talk to the pilots?’ And say, ‘No, we didn’t talk to the pilots,’” Williams said.

Inspectors found 30 deficiencies during an inspection early this year and only four have been corrected, Williams said.

Williams also issued an emergency rule that would allow Planned Parenthood to defer conducting pelvic exams to the day of the procedure. A state rule had required abortion clinics to perform one 72 hours before the abortion.

“We do not want patients having two pelvic exams,” Williams said. “Normally you would do that 72 hours in advance, but if they have their reasons for the way they’ve done that, then we want to listen to them and have patients have that one time.”

The St. Louis clinic started conducting the two pelvic exams as a part of a corrective plan with the state health department. Planned Parenthood physicians stopped following the state rule Thursday.

M’Evie Mead, director of Planned Parenthood Advocates in Missouri, called for Parson to remove Williams as head of DHSS.

“He has made a debacle of this process and has dragged Missouri through shameful, shameful attention and has harmed many, many women,” Mead said, “including the hundred women who had to undergo the medically unnecessary pelvic exam.”

Parson said Planned Parenthood lost its license because it put women in danger and didn’t abide by state regulations.

“Planned Parenthood is losing its license because it failed to meet basic standards of care, placed multiple patients in life-threatening situations, performed multiple failed abortions where patients remained pregnant, and intentionally impeded the state’s health investigation by not allowing health inspectors to talk to the abortion doctors,” Parson said Friday. “If you don’t comply with the law, there will be consequences. If you don’t provide a standard of care that ensures the safety of women, you shouldn’t be allowed to operate. It’s that simple.”

Parson added: “However, if Planned Parenthood can show it is abiding by the laws and regulations here in the State of Missouri, it has every right, under the law, to have its license renewed and continue to provide patient services.”

The state agency made the decision after Planned Parenthood took the state to court over the license renewal. Stelzer earlier this month ordered DHSS to either reject or renew the clinic’s license by Friday.

If the clinic closes, Missouri will become the only state without a clinic that provides abortions.

The dispute over the clinic’s license has resulted in a high-profile court case that’s received national attention, just weeks after Missouri made headlines as one of several states to pass restrictive abortion legislation this year. The court case is not related to the new law, which bans most abortions at eight weeks of pregnancy.

Planned Parenthood sued the state after it refused to renew its annual license. Department officials said they needed to interview physicians who worked at the clinic about instances of care they said compromised patient safety. Those physicians refused to be interviewed, citing confidentiality and other concerns, and the state then said it couldn’t sign off on the license renewal.

Planned Parenthood representatives accused the state of conducting a vague investigation that was a misuse of the state’s regulatory power. In the lawsuit, the organization asked the judge to bar the state from using the interviews as part of the license-renewal process and to declare DHSS’s investigation unlawful.

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A preliminary injunction is keeping the St. Louis clinic’s license in place until the judge makes a more permanent decision. As part of that injunction ruling, Stelzer said the state needed to make a decision to renew or reject the license before Friday.

Once the state makes a decision, the fate of the clinic is back in the hands of the court, Planned Parenthood’s lawyers have said.

The judge could tell the two parties to hash out the dispute before the Administrative Hearing Commission, a government board that resolves disputes between regulators and private citizens and companies.

He could also choose to hear the case on several other issues in the lawsuit, including an accusation that the state’s actions violate equal protection and due-process guarantees, attorneys said.

The lawsuit is about more than simply getting the clinic’s license back, said Me’vie Mead, director of Planned Parenthood Advocates in Missouri.

“What this case is about is not just Missouri, it’s about our sister affiliates in other states across the country who might also be experiencing politically motivated regulatory restrictions,” she said. “We need to open our eyes that the politicians have gone well beyond their role in the state Legislature with laws – while those are very extreme, and they’re pursuing them in my state in a very extreme fashion — they won’t even stop at that. They’re politicizing the regulatory process.”

Missouri Right to Life issued a statement saying it is “relieved and grateful” that Parson's administration, especially Williams and other statewide officials, “are doing all they can to protect the health and safety of Missouri women from an abortion clinic with multiple health violations.”

MORE: Read the letter issued by the state health department rejecting the Planned Parenthood clinic's license:

Clarification: An earlier version of this story misstated state requirements on pelvic exams. State law requires doctors to perform only one pelvic exam on patients seeking an abortion. Planned Parenthood officials have said that a previously required pelvic exam 72 hours before an abortion in effect compelled doctors to perform two such exams as one was medically needed immediately before the procedure. State health officials dropped the 72-hour pelvic exam requirement last week.

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As the deadline nears for the state’s decision on whether to renew the license for Missouri’s last remaining abortion clinic, doctors at Planned Parenthood have announced they have stopped following a state rule that, in effect, makes them conduct two pelvic exams before providing the procedure.

The St. Louis clinic had started conducting the exams several weeks ago as part of a corrective plan between the organization and the Missouri Department of Health and Senior Services. The plan was put in place after the agency found Planned Parenthood wasn’t in compliance with state rules, which include an initial pelvic exam as part of its 72-hour consent law.

On the same day last week a Missouri judge issued an order keeping open the state’s only abortion clinic, the Illinois Senate passed the Reproductive Health Act, guaranteeing women have the right to reproductive health, including abortion.

Tuesday, a St. Louis Circuit Court judge will hear arguments about whether the Missouri Department of Health and Senior Services may continue to deny a renewed license to Reproductive Health Services of Planned Parenthood of the St. Louis Region.